Sample Record

Owner Lab

  • CT SC - 3665 - Shingle Springs

DIME Sample ID 2022-05-25-47

Project Information

Project IdentifiersProject ID: 214572
DEA: 034E62U4
EFIS: 0319000068
DIST-CO-RTE-PM03-ED-50-18.5/24.2
Award Date05/04/2020
Closeout DateNot set
Work DescriptionCONSTRUCT UC, MED BARRIER, DRAINAGE SYSTEMS & HMA OVERLAY.
Location DescriptionEL DORADO COUNTY IN AND NEAR PLACERVILLE FROM MOSQUITO ROAD UNDERCROSSING TO SCHNELL SCHOOL ROAD UNDERCROSSING AND FROM 0.2 MILE WEST OF STILL MEADOW ROAD TO 0.2 MILE EAST OF CARSON ROAD
QA Service Level1 (Verified on 03/18/2020)

Sample Information

Sample Taken Date05/25/2022 Sample Unique Key47
Will the laboratory/organization for which you are a member perform testing on this material sample?No Date that the sample was received by the laboratory/organization performing the testingNot set
Sample typeQuality Assurance A brief description of the sample4x8 concrete cylinders
The quantity of what the sample constitutes28.5 CY From where was the sample collectedJob Site
First name of sampler or witnessed byRaymond Last name of sampler or witnessed byMacy
Title of samplerSR Telephone number of sampler9162035039
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameSyar Concrete Shingle Springs Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier
Structure name

Material Information

Material TypeConcrete The concrete mix design numberCT072CR5WA
The truck number from where the sample was collected The batch plant ticket number from where the sample was collectedTBD
Concrete batch plant The fabricator/manufacturer designation for the sample
A detailed description of where the material sample was collectedBack of truck chute Where the material sample would have been placed if not sampled
From Lot No. Bag Lot No.

Submitted Tests

DIME Test IDTest MethodTester Name, Testing LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
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Sample File Attachments

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Test File Attachments